Disgruntled Rant

In the midst of being sick, I have somehow perserved my ability to think (at least somewhat) clearly and continue to maintain my ability to organize and keep track of information. As I wade through a sea of paperwork and out-of-network bills from multiple doctors and labortories, I feel empathy for those who face this daily, for years, and do not have the stamina or support to make sense of these papers. I feel sick to my stomach as I imagine 90 year old women trying to make sense of the Explanation of Benefits for her husband's healthcare. I could vomit if I think too long about her on the phone with a customer service agent, trying to understand why she has not seen any correspondance regarding her claim that she sent in four months ago.

Here I am, day three (or maybe four) or trying to track down payments from my insurance company for treatments, doctors visits, and medications. I just got taken off of hold and spoke to the woman I will endearingly refer to as Agent B. She was checking with Karen, Agent A, who I spoke with for over 30 minutes last week. I was simply calling to follow up on the re-submittion of SEVEN claims that somehow failed to be keyed into her system when I mailed them in last December.

Okay, Agent B just got back to me.
Apparently Karen had no idea what she was talking about.
And now I am on hold again.

I have now been on the phone for 29 minutes with Anthem. The claims I discussed with Karen last week . . . the claims she said where not keyed into her system . . . but that she found the "hard copies" of . . . the claims she said she would re-send to be reviewed for out-of-network reimbursement . . . those claims, apparently do not exist anymore.
They actually were never sent in.
Imagine that.

Isn't that amazing!
Claims that existed last week . . . that were held in the hands of a disgruntled custormer service agent named Karen, just last week, actually do not exist anymore.
I had no idea they were able to back into time and erase the existance of a material object.
They should be using their powers for a lot more than filing insurance claims.

So, now I wait to speak to "a supervisor". I look forward to this conversation.

I have now been on hold for 4 minutes, anticipating our conversation.

I read an article a few years ago in Real Simple Magazine about what really goes on behind the scenes in customer service departments.

The reaility is that while Agent B was "checking with Karen" about my paperwork (that is capable of breaking the time-space continuim), she might have more likely been taking a coffee break. And this "supervisor" I am about to speak to . . . most likely the woman that Agent B is currently shooting the breeze with over a cup of instant coffee grains and some room temp water.

The moral of the story in the Real Simple article was this: be as sweet as honey when you speak to a customer service representative.
Because your destinay lies in their hands.

After 12 minutes, I was informed that after a long, heart-felt conversation with "the supervisor" they found the claims and guess what - even the notes in my computerized file documenting that the claims HAD in fact been sent in to be processed. Amazing! Just moments ago, she read to me straight from the same file stating that the claims had not been sent in and that the case was closed.

The claims have been sent in and are existing in a sort of paperwork purgatory for the next 30 days (does that mean 22 for me, since I am positive Karen sent them in promptly 8 days ago when we spoke!?) and that is the reason she could not track them down in her system.

Now I need to speak to somebody about my perscription reimbrusements.
No problem.

I have been transfered to Perscription Claims.
Guess who answered the phone?
Client advocacy.
Turns out Perscription Claims does not actually have a phone number that receives calls.
She will now transfer me back to the original team who is helping me with my medical claims.

Now I have been on hold for five minutes anticipating the reconnection with Karen and Agent B.

Guess what?
I get to give ALL of my information all over again.
This time to Agent C.
She asks for the dates of each and every medication I am inquiring about.
I list the first one.
And then I apologize in advance for my crankiness.
I really had been as sweet as honey. . .
up until this most recent transfer
and please excuse me because I have now been on the phone with your company for 50 minutes and nothing has really been resolved yet.


I continue on, listing each perscription.

Turns out the perscription reimbursement check was distrubuted to me months ago.
Yes, I vaugely remember a check in the amount of $41 and some odd cents.
I apologize, Agent C, for wasting your time.
That was my mistake.
I must have somehow, in all of this paperwork, managed to get a little confused.

55 minutes and 46 seconds of my life.
And then we are finished.
There is silence on the other end.
None of the scripted: "thank you for choosing anthem. is there anything else I can do to help you today? have a great day!"
I thanked Agent C and wished her a great day.

All I heard from her, "You too."

Gee, thanks.

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Blogger Jennifer of Dog.Yarn.Knit. said...

as my cousin, eric, likes to say, "poop on a stick."

10:15 AM, April 18, 2007  

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